New Immunization Requirements for
Kindergarten, 6th Grade, and College Students

RALEIGH – The North Carolina Commission for Public Health has made several changes to the rules regarding vaccination of school-aged children and college students. Effective January 1, 2008, the administrative rule, 10A NCAC 41A.0401, has been changed, adding requirements for a booster dose of Tdap (tetanus, diphtheria, and acellular pertussis) vaccine and a second dose of mumps vaccine. These rule changes will go into affect beginning with the 2008-09 school year.

The new rule states that a booster dose of Tdap vaccine is required for the following individuals:

All students attending public school who are entering the 6th grade on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid.

All students not attending public schools (i.e., private, home-school, non-traditional schools) who are 12 years of age on or after August 1, 2008, if five years or more have passed since the last dose of tetanus/diphtheria toxoid.

Individuals enrolling in college or university for the first time on or after July 1, 2008, if a tetanus/diphtheria toxoid or tetanus/diphtheria/pertussis vaccine has not been administered within the past 10 years.

The administrative rule change also impacts mumps vaccination. Individuals are now required to receive a second dose of mumps vaccine before enrolling in school, college or university for the first time. However, any child entering school prior to July 1, 2008 is not required to receive a second dose of mumps vaccine. Children were previously required to have only one dose of mumps vaccine. Most children already receive two doses of the MMR vaccine (measles-mumps-rubella) by age four. Therefore, this rule will primarily affect children who received single antigen doses of the vaccines.

“Since these vaccinations are required, students will be able to receive the booster dose of Tdap and the second dose of mumps for free,” said Dr. Leah Devlin, State Health Director. “Parents simply need to set up an appointment with their child’s physician or local health department to receive the immunization prior to school entry. The vaccine will be provided at no charge; however, the physician may charge a small fee to administer it.”

The Immunization Branch has developed a variety of resources that the schools and health care providers can use to educate staff and parents/guardians about the rule changes. A toolkit of materials will be sent to every school around the end of March/beginning of April. Until the kits arrive, all of the educational materials found in it are available and can be found at www.immunizenc.com. Schools are encouraged to use these materials to educate their staff and parents about the immunization rule changes.

“These rule changes were designed to help reduce the incidence of whooping cough and mumps disease among North Carolinians,” said Beth Rowe-West, RN, BSN, and Head of the Immunization Branch. Whooping cough is a highly contagious respiratory infection. Most children are fully protected against it prior to entering kindergarten, but immunity to whooping cough wanes after about 10 years. “This rule allows us to reduce the impact of this deadly disease and better protect our children by boosting their immune systems.” These rule changes are based on recommendations from the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices.

For more information about the immunization rule change, visit www.immunizenc.com or contact your physician, your local health department, or the Immunization Branch at 919-707-5550.